Angiotensin Receptor Blockers confer cardioprotection in males but not in females with type 2 diabetes and nephropathy

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    Angiotensin Receptor Blockers confer cardioprotection in males but not in females with type 2 diabetes and nephropathy

    MJ Pena, ST de Vries, D de Zeeuw, PGM Mol, P Denig, HJL Heerspink
    Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Objective: We assessed sex differences in cardiovascular (CV) and renal outcomes of treatment with angiotensin receptor blockers (ARBs) in patients with type 2 diabetes (T2D) and nephropathy.

    Methods: Data from the RENAAL and IDNT trials were used, assessing the effects of losartan respectively irbesartan. The CV outcome was time to first event of a composite of stroke, myocardial infarction, CV death or hospitalization for heart failure. The renal outcome was time to first event of end-stage renal disease or doubling of serum creatinine. Sex differences in the efficacy of ARBs were assessed by a sex*treatment interaction in a Cox proportional hazards model. The models were adjusted for baseline levels of systolic blood pressure, albuminuria, estimated glomerular filtration rate (eGFR), glycated haemoglobin (HbA1c), total cholesterol, and hemoglobin.

    Results: A total of 1737 males and 924 females were followed for a median of 2.9 years. During follow-up 872 CV events (31% in females, 34% in males) and 778 renal events (36% in females, 25% in males) were recorded. ARB treatment decreased CV risk in males (HR: 0.79, 95% CI: 0.67-0.94), but not in females (HR: 1.12, 95% CI: 0.88-1.43) (p-value for interaction = 0.027). Males also had a larger, but non-significant, benefit for the renal outcome.

    Conclusions: ARB treatment confers cardioprotection in males but not in females with T2D and nephropathy. Additional analyses of sex differences are needed when assessing treatment efficacy.
    Originele taal-2English
    StatusUnpublished - 1-jun-2017
    EvenementDutch Pharmacological Society (NVF) spring meeting - Utrecht, Netherlands
    Duur: 1-jun-20171-jun-2017

    Conference

    ConferenceDutch Pharmacological Society (NVF) spring meeting
    Land/RegioNetherlands
    StadUtrecht
    Periode01/06/201701/06/2017

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